Kaposi's sarcoma in patients with and without human immunodeficiency virus infection, in a tertiary referral centre in Kenya

The clinical features of Kaposi's sarcoma (KS), in patients with and without HIV infection, were investigated in a tertiary referral centre in Kenya between 1997 and 1999. Although 186 cases were identified prospectively, the data analysis was restricted to the 91 (49%) cases who had pathological confirmation of Kaposi's sarcoma and documented HIV serostatus. Among these 91 subjects (58% of whom were male), the age-group holding the largest number of KS cases was that of individuals aged 31-40 years; most of the paediatric cases were aged 6-10 years. The ratio of HIV-seropositives to HIV-seronegatives was 8.5:1 for the adult cases and 0.9:1 for the paediatric. Of the signs and symptoms of Kaposi's sarcoma seen at presentation, only peripheral lympadenopathy was found to be significantly associated with underlying HIV infection (P = 0.05). The median survival was 104 days. It is apparent that, as the HIV epidemic advances in regions of the world with endemic KS, the clinical presentation and natural history of the endemic KS are blending with those of the epidemic or AIDS-associated disease, leading to a reduction in the mean age of the cases and a nearly identical incidence in men and women. In regions of the world where patients have ready access to such chemotherapy, the impact of treatment with highly active antiretroviral drugs on the incidence and natural history of KS has been dramatic. It will be important to monitor the clinico-pathological features of KS in the developing world, as more active antiretroviral regimens become available in clinical practice there.

Dietary patterns as compared with physical activity in relation to metabolic syndrome among Chinese adults

AIMS

To examine the nationally-representative dietary patterns and their joint effects with physical activity on the likelihood of metabolic syndrome (MS) among 20,827 Chinese adults.

METHODS AND RESULTS

CNNHS was a nationally representative cross-sectional observational study. Metabolic syndrome was defined according to the Joint Interim Statement definition. The "Green Water" dietary pattern, characterized by high intakes of rice and vegetables and moderate intakes in animal foods was related to the lowest prevalence of MS (15.9%). Compared to the "Green Water" dietary pattern, the "Yellow Earth" dietary pattern, characterized by high intakes of refined cereal products, tubers, cooking salt and salted vegetable was associated with a significantly elevated odds of MS (odds ratio 1.66, 95%CI: 1.40-1.96), after adjustment of age, sex, socioeconomic status and lifestyle factors. The "Western/new affluence" dietary pattern characterized by higher consumption of beef/lamb, fruit, eggs, poultry and seafood also significantly associated with MS (odds ratio: 1.37, 95%CI: 1.13-1.67). Physical activity showed significant interactions with the dietary patterns in relation to MS risk (P for interaction = 0.008). In the joint analysis, participants with the combination of sedentary activity with the "Yellow Earth" dietary pattern or the "Western/new affluence" dietary pattern both had more than three times (95%CI: 2.8-6.1) higher odds of MS than those with active activity and the "Green Water" dietary pattern.

CONCLUSIONS

Our findings from the large Chinese national representative data indicate that dietary patterns affect the likelihood of MS. Combining healthy dietary pattern with active lifestyle may benefit more in prevention of MS.

Effects of the silencing of hypoxia-inducible Factor-1 alpha on metastasis of pancreatic cancer

BACKGROUND

Hypoxia plays a crucial role in the development of solid tumors. Hypoxia-inducible factor-1alpha (HIF-1alpha) is essential for this process, and has been suggested to be a target for cancer therapy. New therapeutic approaches for pancreatic cancer are needed owing to the extremely poor prognosis, in large part as a consequence of high rates of metastasis. The mechanism remains to be explored.

AIM

To illustrate the role of hypoxia-inducible factor-1alpha in pancreatic cancer metastasis and the value of the molecule as a target for pancreatic cancer therapy.

MATERIALS AND METHODS

To address this shortcoming, we used both in vitro and in vivo approaches to evaluate the overall effects of HIF-1alpha on pancreatic cancer. We used a plasmid encoding small interfering RNAs (SiRNAs) to silence HIF-1alpha expression in the Panc-1 pancreatic cancer cell line, and used a series of assays to detect changes in gene expression at the protein and mRNA levels, cell proliferation, cell apoptosis, and the abilities of cells to migrate under both hypoxia and normoxia conditions.

RESULTS

Both in vitro and in vivo analysis suggested that hypoxia significantly promotes cell proliferation and migration, resulting in metastasis. Pancreatic cancer cells in which HIF-1alpha expression was inhibited were less invasive, with reduced resistance to hypoxia, impaired migration, and reduced capacity to cause metastasis.

CONCLUSIONS

HIF-1alpha may be a dominant factor driving the metastatic progression of pancreatic cancer and can be a potent therapeutic target for the disease.